Active NPI
Emily P Bandeen, DDS
- Dentist
- Battle Creek, MI
National Provider Identifier
1417067158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901019417
- Practice address
- 4602 Beckley Rd
Battle Creek, MI 49015-7932 - Phone
- (269) 963-4118
- Fax
- (269) 963-4167
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901019417 | MI | Primary |
Addresses
Primary practice location
4602 Beckley Rd
Battle Creek, MI 49015-7932
Mailing address
4602 Beckley Rd
Battle Creek, MI 49015-7932
Phone (269) 963-4118
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4911093 | Medicaid | MI | |
| 4911119 | Medicaid | MI |
Other names 1
- Miss Emily Pala
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901019417 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bandeen Orthodontics | Dentist | Past | Accepting new patients |
| Residential Home Sleep Services | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Battle Creek, MI
- NPI 1043688013
-
- Durable Medical Equipment & Medical Supplies
- Battle Creek, MI
- NPI 1508239385
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403481600000",
"number": "1417067158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4602 BECKLEY RD",
"city": "BATTLE CREEK",
"state": "MI",
"postal_code": "490157932",
"telephone_number": "269-963-4118",
"fax_number": "269-963-4167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4602 BECKLEY RD",
"city": "BATTLE CREEK",
"state": "MI",
"postal_code": "490157932",
"telephone_number": "269-963-4118",
"fax_number": "269-963-4167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANDEEN",
"first_name": "EMILY",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2014-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901019417",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4911093",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4911119",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "EMILY",
"last_name": "PALA",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Battle Creek, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.